Disorders of sensation Flashcards
Common causes of peripheral neuropathy
Diabetes
HIV/AIDS
Hep C
Medications (Chemo)
Alcohol
Toxins
Inherited neurpatjies
Autoimmune disease
Cancer
Symptoms of peripheral neuropathy
Burning feet
Parasthesia
Numbness
Lighting like shocking pains
Hypersensitive feet
‘feet feels like block of ice or something squeezing feet’
DDx for painful feet
Peripheral neurpathy
Radiculopathy
Claudication / vascular disease
Plantar fasciitis
Gout
RA
Lupud
Sjogren’s
Morton’s neuroma
OA
paraneoplastic sensory neuronopathy treatment
Gabapentinoid e.g. gabapentin- first line
Anti convulsants
Anti depressantd (TCA and SNRIs)
Weak opiods (tramadol)
Lidocaine patches / creams
Exercise, diet, weight loss
What is herpes zoster
Shingles
Herpes zoster symptoms
Pain, tingling or ithcing 2-4 days prior to appearance of rash (vesicles)
What is Herpes opthalmicus
Shingles spreads to face and nose and eyelids - need immediate referral to opthamology or may lose sight
Herpes zoster treatment
Antiviral - aciclovir, valacyclovir, famiciclovir
Pain control
What is post herpetic neuralgia and how does it present
Persistence of pain in area previously affected by herpes zoster for more than 3 months after resolution of rash
pain is electric shock like
Deep severe itching
Hypersensitive skin
RF for post herpatic neuralgia
Advances age
Female
Severe pain
Post herpetic neuralgia treatment
anti-convulsants - gabapentin
Antidepressants - TCA and SNRI
Weak opiod agonist - tramadol
Lidocaine patches / topical creams
What is radiculopathy and its presentation
Pain in arm/leg which radiates usually to legs
- electric shock like pain
- pain worse in some positions
- often initiated by trauma, heavy lifting, repetitive motions or prolonged sitting
send to neuro urgently if laxity of rectal tone or faecal incontinence
Causes of radiculopathies
Trauma
herniated disc
Nerve root swelling
invasion of cancer into bone or spinal canal
Osteophytes from arthirits
Ix for radiculopathies
MRI
